Overview of Post Nasal Drip

Post nasal drip, which is also called upper airway cough syndrome, is best described as a runny nose in the back of your throat. Conditions such as allergies and infections can trigger the production of excessive mucus that drips down your throat. When you feel like you are swallowing or coughing up a large amount of thin or thick mucus, it often becomes bothersome.

It is normal to have a layer of mucus in the back of your throat. This mucus helps protect you from infection and it lubricates your throat. Post nasal drip occurs when the mucus increases.

Post nasal drip is typically diagnosed based on your complaints, and there are a number of effective home remedies and medications that can help clear it up.

Post nasal drip generally lasts for a few days or weeks, depending on the cause. Sometimes, it can be chronic, and you may experience it for months on end. The effects are generally mild and you can have a combination of symptoms.

Symptoms of post nasal drip include:

• Feeling like you need to clear your throat
• A sore throat
• Occasional coughing
• Scratchy, tickling, or itching in the back of your throat
• Burning feeling of your throat
• The sensation of a lump in the back of your throat
• Hoarse voice
• Losing your voice
• Persistent cough

These symptoms can fluctuate throughout the day, and you may feel worse after lying down for a while or after speaking for a long time.

When To Seek Medical Care

Post-nasal drip does not always require a consultation with a medical professional, and it often goes away on its own.

However, you should see a doctor if:

• Your symptoms last longer than a few weeks
• You have difficulty swallowing
• You feel like you're choking
• You have trouble breathing
• You have a fever, vomiting, or ear pain—which are signs of an infection that requires medical treatment

There are a number of different causes of post nasal drip. In some instances, your body produces more mucus, and in others, your body might not clear the mucus as quickly as usual, which makes it build up.

Common causes of post nasal drip include:

Long Lasting Medical Conditions

• Allergies to pollen, mold, dust, or dander
• Swallowing problems
• Acid reflux—gastroesophageal reflux disease (GERD) 
• Anatomical abnormalities such as a deviated septum or enlarged turbinates
• Certain medications, including contraceptives and antihypertensives to control blood pressure
• Rebound congestion due to overuse of pseudoephedrine nasal sprays

Temporary, Self-limited Medical Conditions

• Infections such as the common cold (for example, from CMV, RSV, adenovirus, and other viruses), influenza, and sinusitis 
• Seasonal allergies
• Pregnancy-induced rhinitis 
• Hormone fluctuations
• Strep throat 

Reactions to Sudden Triggers

• Eating spicy foods
• Eating dairy products
• Foreign objects stuck in the nose
• Exercise-induced rhinitis
• Pet allergies

Post nasal drip is generally diagnosed based on your symptoms. When you cough, you might notice thick or thin phlegm, and this is typically a sign that post nasal drip is part of your condition. Typically, your other symptoms besides post nasal drip can help in determining the cause.

Physical Examination

If you have a fever, your post nasal drip may be caused by an infection. Your doctor would look in the back of your throat to see if there is any redness or swelling, and would also look for and ask about other signs of infection (such as headaches, fever, chills, muscle aches).

If your phlegm is blood tinged, this could be a sign of a gastrointestinal or pulmonary infection or a medical condition that requires further evaluation.

Diary and Allergy Testing

If your post nasal drip symptoms recur every few days or weeks and resolve in between episodes, then it could be related to food or to an allergic reaction. Your medical team may encourage you to keep a diary of your symptoms, noting what you ate and what you may have been exposed to (such as pollen or pets). Allergy testing may help pinpoint the trigger.

Imaging

If you have post nasal drip frequently, or all the time, then you could have an anatomical cause—such as a deviated septum. You would need to have a physical examination and imaging tests so that your medical team can visualize any variations to identify an anatomical cause of your symptoms.

Interventional Tests

Post nasal drip diagnosis may involve interventional tests if GERD is believed to be the possible cause. GERD is usually accompanied by heartburn or abdominal discomfort. GERD diagnosis may include tests such as direct laryngoscopy (which visualizes the upper throat), 24-hour pH probe (which can test for acid reflux), or esophagogastroduodenoscopy (which visualizes the lining of your esophagus, stomach, and small intestine).

There are a number of strategies for treating post-nasal drip. Avoiding triggers (such as foods, pets or dust) can prevent your symptoms if you know what your trigger is.

Symptomatic relief can help you if the cause of your post nasal drip is expected to resolve (such as pregnancy or a cold). Over the counter (OTC) or prescription medication can help with seasonal allergies. And treatment of the underlying cause may be necessary when you have chronic post nasal drip (such as with an anatomical variation or GERD).

Some tips that can make you more comfortable, regardless of the cause include:

• Drinking a lot of water to lubricate your throat and keep your mucus thin (thin mucus is less bothersome)
• Using a cool mist humidifier at night while you sleep
• Using a vaporizer, diffuser, or neti pot, which can be infused with essential oils, such as peppermint or eucalyptus

Congestion, sore throat, and cough can often be managed with OTC therapies.

• Acetaminophen or cough lozenges can ease a sore throat
• Saline nasal spray can decrease congestion
• Medicated nasal spray such as Afrin (oxymetazoline) can help you breathe more comfortably
• Vapor rubs may help reduce congestion
• Mucinex (guaifenesin) can decrease congestion
• Claritin (loratadine) or Sudafed (pseudoephedrine), Benadryl (diphenhydramine) are antihistamines that may help to relieve congestion

Be sure to consult your doctor or pharmacist before using new medications and avoid using decongestants for more than three days at a time.

There are also a number of prescription medications used for the treatment of post nasal drip. For example, treatments for hay fever include some OTC and some prescription medications. For persistent post-nasal drip, or for post nasal drip complicated by asthma, Atrovent (ipratropium bromide) or steroids may be prescribed.

If you have a bacterial or fungal respiratory infection, you will need antibiotics.

GERD requires treatment with a multi-pronged approach, which includes avoiding fatty foods and spicy foods, OTC or prescription medications, and sleeping with your head slightly elevated, rather than flat.

Anatomical variations may require a surgical repair, such as sinus surgery, submucosal resection of the nose, or turbinate reduction

A Word From Verywell

Post nasal drip is very common. If you experience it a few times per year, then there is probably nothing to worry about. But if you seem to have post nasal drip frequently or on a regular basis, you should talk to your doctor about it. You might have an underlying cause that can be treated.